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Thursday, August 23, 2007

Pain Threshold

Once long ago, lost in the mists of time, I visited the dentist in England.

Was it ever thus?

I went along for a particularly nasty procedure, which involved serious anesthesia. The kindly dentist assured me that he would gradually increase the dosage and within 5 – 10 minutes I would feel nothing. Once I felt nothing, he would proceed. I had nothing to worry about, not at all.

After half an hour and an ever increasing dose of pain medication, I was still lively and alert. He upped the dosage again and again and again. After an hour and a half I was dosed. I have a vague recollection that sounded like “enough to put out a cart horse!” and then nothing. To this date, I do not know if I need more anesthetic than Mrs. Average or whether I just need longer for it to take effect?

I have reason to recall this incident as I sit by the bedside of my son in the Emergency Room. Do not fear, it is only a squished finger, but you can’t be too careful. The bones are perfect. The gaping wound is a lucky escape. A finger in the hinge of a door, is likely to come off the worse in battle. During the last hour and a half, we have experienced lots of ‘owie, it hurts bad,’ but no tears. Broadly speaking his pain threshold is unusually low. He tumbles and bumbles about his life full of scratches and bruises, with seemingly no ill effects.

At the triage station we experience a meltdown. “Is he in a great deal of pain?” asks the nurse. I attempt a smile as I calm my son in a heap on the floor. I promise him faithfully that although he has missed ‘electronics time’ that whenever we manage to return home, he will be allowed to have his 30 minutes reward.
“But it will be night!” he squeaks, incredulous.
“I know, but that doesn’t matter. You can play electronics in the middle of the night, just this once.”
“But dah rule!” he gasps, mystified.
“We’ll skip the rule for tonight, just for tonight. Any time that you go to the ER will be an ‘electronics at night’ night.” He bristles with delight, let’s his head drop to my sternum and mutters, “Fank you mom, you are dah bestest, ever!” His face is alive with glee and excitement. Does he even have a blood drenched finger? He chortles and wriggles with joyful anticipation.

A Tuesday night is a relatively quiet night so we are truly fortunate to glide through the bureaucratic system. He does not seem particularly perturbed by the vast quantities of blood.

I am in my best all star cheerleader mode. I am so upbeat and jolly that I know I am the sort of person I would shoot, that is if I were not an upstanding member of the anti gun lobby. I take care to assert enough positive attitude to assure my son that we will, eventually, leave the hospital with his finger still attached to his person, his primary concern. His secondary concern is that he will be unable to play any of his electronic games with a malfunctioning finger.

I greet all pertinent members of staff and discretely point to the ‘speech delay’ part of his notes. They in turn, give me the benefit of the doubt: not a deranged hysterical mother.

I explain how it happened and my son interjects with his cartoon, hysterical voice, “she did it to me!” he bellows. He thrusts an accusatory finger at the centre of the room, where there is an empty space. The doctor looks askance, but I don’t particularly care. I continue. High jinks between siblings, an accident. “I’m gonna get her good!” he continues, in the menacing, ‘evil doer,’ cartoon character. I don’t know if the doctor is familiar with scripting, but it’s irrelevant to the current proceedings. “When I git me home, I’m gonna do her wrong!” he adds, in what seems to my untutored ear, like a perfect Texan accent. I don’t explain or excuse.

A needle of any kind, is not generally an attractive tool in a hospital. The staff are careful, they do not let him see it. Jabs, or shots, as we say in the States, alway produce a negative reaction, but it has to be done. I hold his other hand, his free hand, as the rest of his body is encased in a blue Velcro restraint, for his and the staff’s protection. It would be difficult for any child to remain still. The more still he is, the quicker the procedure will be, the sooner he will be released and all will be well.

I stroke his hair and hold his hand. I talk slowly and calmly. The local anesthetic induces a squeak of pain and surprise, his body tenses with the squalk of “oweei!” He holds it together with a quivering lip and moist eyes.

When the threaded needle pierces his flesh his eyes spout fountains of water, arcing rivulets. They fly from each one, his body rigid and arched, mouth open with screams that rip and shred the air.

“He can’t feel it. It can’t hurt him,. Sometimes they get confused between pain and sensation,” she adds catching my eye. Her stitches are swift and all is over within a minute. It is the longest minute that either of us have ever experienced. I rip off my bifocals and wipe my face, as he does not need confirmation that I have failed and betrayed him, that I should have anticipated and protected him. I am tempted to bite the physician because the correct words escape me. So base, so visceral, so instinctive.

Nothing will convince me that it was sensation rather than pain, but of course, we parents know nothing, far too emotionally involved.

Should you need a little light relief, come and visit me "here."


Jeni said...

Needles and small children - not usually a very nice combination for any involved! My older daughter for many years required at least three people to hold her down if a shot was required whereas my son barely would even bat an eye. The granddaughter has had a really bad year with respect to doctors -most of it of the imagined type of bad things and she would rant, go into a meltdown as soon as her name was called in the waiting room. However, last week, we saw progress at her last physical - she only had a fit over the thermometer -in her ear. However a day or two later at home, she was carrying around a little (empty) squirt gun and putting it in my ear, her dad's, her mother's, pulling it out and looking at it and mumbling something about temperatures. She would also put it in her ear. So, progress moves on doesn't it?

Eileen said...

Of corse we parents know nothing. Of course our children who have a high tolerance to pain should scream and cry like that just because of a sensation. I am not a big fan of most doctors!

Sorry you both had to go through that. I hope his finger is feeling better now! I especially hope the hurt finger has not effected his ability to play his video games.

Rachel said...

Poor little guy. I hope his finger is ok and that it isn't giving him any trouble when he has his electronics time.

Anonymous said...

this right here is the best line from your story: "They in turn, give me the benefit of the doubt: not a deranged hysterical mother."

first of all may i say that you write so well. i am right there with you as you waited with your son.

we have been so lucky thus far...i have not had to take my son to the emergency room yet. i can't even imagine. kudos to you for handling things so well and then being able to write about your experience so eloquently.

i hope your son's finger is doing better!


Linda said...

I'm sure that the pain your son felt in his finger was matched equally by the pain in your heart with each stitch taken.

I hope you are both doing well now and that this will soon be just a dim memory and not something that needs to be repeated often (though I'm afraid that my friend Cyndi has spent way too many hours in an ER for just these sort of things).

dgibbs said...

I was one of those kids that had to get stitches quite a few times. Mostly because I refused to wear shoes. I remember the needle from the shots hurting but not the stitching.

One thing they always did for me was wait for the meds to take effect and then come back in, poke on the area to be sewn and ask it I could feel it. If I could they shot me with more anesthesia if I couldn't they would then sew me up.

I hope they tried to give him the same curtisy.

The Shepcarpclan said...

Poor guy, poor mom. I went through something very similar with Caleb. They kept injecting tryint so sew, injecting, trying to sew. He insisted he could feel it in his finger. Finally he had enough of being sat on told them, "fine just sew it, but I can feel it". I know he could no matter what they said. Hugs to you both.

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